Across Canada, the next generation of multiple sclerosis (MS) researchers is working together on an interdisciplinary longitudinal study to understand how and why MS progresses differently in different individuals. From the microscopic mechanisms that lead to changes in the brain, to the economic impact of the disease on the Canadian healthcare system, the Canadian Proactive Cohort in MS (CanProCo) study will look at the disease from all angles.

MS is an autoimmune disease that occurs when the body’s immune system attacks myelin, the fatty material that insulates neurons and enables rapid transmission of electrical signals. When myelin is damaged, communication between the brain and other parts of the body is disrupted, leading to vision problems, muscle weakness, difficulty with balance and coordination, and cognitive impairments. The causes of the disease and mechanisms of its progression remain unknown, though scientists have implicated genetic variations and environmental factors, including a lack of Vitamin D.

Canada has one of the highest rates of MS in the world. An estimated 100,000 Canadians are living with MS, and the disease is most often diagnosed in young adults aged 15 to 40.

CanProCo is the first national effort directed at understanding progression in MS, and will look at the biological, clinical, epidemiological, and health systems factors underlying disease progression. To do so, the project is drawing on expertise from nearly 50 researchers at five sites across Canada. At UBC, Dr. Anthony Traboulsee will lead recruitment at the UBC Hospital MS Clinic at the Djavad Mowafaghian Centre for Brain Health; Dr. Shannon Kolind and Dr. Roger Tam will lead the neuroimaging pillar of the study; Dr. Jacqueline Quandt will provide an immunology perspective; and Dr. Larry Lynd with the Faculty of Pharmaceutical Sciences will provide a health economics perspective to better inform the “big picture” in MS.

“The exciting part of this research is who we’re engaging,” said Dr. Traboulsee. “This really is an effort led by our younger researchers, but also our patient community, and experts from areas outside of traditional siloes. There is tremendous talent across Canada, and so we believe we’re working towards a model for what research can be when we work across disciplines toward a single goal.”

For Dr. Karen Lee, Vice-President, Research at the MS Society of Canada, this five-year national project represents an opportunity to bring many lines of inquiry into focus. Dr. Lee has been a champion of this initiative since 2013.

“This is really a convergence of many different areas of research, and if we can do this right from the start, we’re hopeful that we will be able to answer some of the tougher questions we hear from our community,” said Dr. Lee. “We’re asking big questions, bringing in truly varied perspectives, and leveraging our discoveries to date.”

Canadian MS research has a rich history of success, and CanProCo will build on that important legacy. The study will follow 1,000 people with MS from five sites across Canada, including here at UBC.

In addition to the wealth of information the researchers will collect, the team will also evaluate treatment effects, the impact of early diagnosis and treatment on progression, and the impact of physical activity and other non-pharmacologic interventions.

“The results from the cohort study have the potential to provide a better understanding of the biological mechanisms of progression, risk factors for progression, biological markers indicative of progression, and how people will progress over time,” said Dr. Lee.

“CanProCo offers an unprecedented opportunity to evaluate a spectrum of factors related to MS onset and progression,” says Dr. Traboulsee. “The insights we glean from this research will inform clinical practice, health policy, and a new generation of studies; we’re not only working to understand MS more fully, we’re also putting a foundation in place for future research in Canada and beyond.”

CanProCo is funded in partnership between the MS Society of Canada and Brain Canada.